Skin cancer also strikes people of color

Flor Mayoral understands why so many of her Hispanic patients ignore warnings about too much sun, never use sunscreen and express absolute shock when they are diagnosed with skin cancer.

The Miami dermatologist says her patients have heard that those most at risk have pale skin, blond hair, blue eyes and freckles. "I am not blond, I don't have blue eyes and I don't have freckles," she says. "So I think you are not talking about me." And it's true that the risk for skin cancer is lower the darker your skin is — meaning most Hispanics and blacks in the USA are at lower risk than most whites.

But lower doesn't mean zero. And, when it comes to melanoma, a dangerous form of skin cancer, a lack of concern can be deadly. Studies show that though blacks and Hispanics are much less likely than whites to get melanoma, they are much more likely to be diagnosed at a late stage and die from it.

One recent study of 41,072 melanoma patients in Florida found advanced cases in 12% of whites, 18% of Hispanics and 26% of blacks

"This is a tragedy because it's preventable," says Claudia Hernandez, a dermatologist in Chicago. "Unlike a lot of cancers that are internal and cannot be seen, these are cancers that can be caught at an early stage."

But Hernandez says her Hispanic and black patients tell her: "We do not get skin cancer."

The issue has captured the attention of major medical groups. At a meeting in June, the American Medical Association passed a resolution calling for greater skin cancer prevention efforts aimed at "communities of color."

This summer, the American Academy of Dermatology is dispatching doctors to discuss the risks on radio stations popular with black and Hispanic listeners.

Mayoral says she'll do those interviews in Spanish. "The message will be that you, too, can get skin cancer," she says. "It doesn't matter what color your skin is: If you have a mole that is changing in size or color or is bleeding, you need to have it looked at."

The AMA resolution said people of all skin colors should use sunscreen, limit sun exposure and have regular skin exams.

The most common skin cancers — those that rarely kill but can be disfiguring — are clearly linked to accumulated damage caused by the sun over a lifetime. The link between sun exposure and melanoma is more complex, but studies suggest indoor tanning, sunburns and bouts of intense exposure (including sun-soaked vacations) do raise the risk.

Everyone should take heed

Sun exposure does have at least one benefit: It boosts vitamin D levels, which are often low in dark-skinned people. But the dermatology group says food and supplements are safer sources.

Still, years of warnings haven't persuaded most whites to cover up. Persuading blacks and Hispanics is much tougher, says Robert Kirsner, a researcher at the University of Miami. In one study, he and his colleagues found Hispanic teens were less likely to use sunscreens, more likely to use a tanning bed and less concerned about skin cancer than white teens — even when their skin tones were the same.

Health groups should warn everyone about sun exposure, he says. But blacks and Hispanics may benefit even more, he says, from campaigns that urge them to see a doctor if they notice new, changing or otherwise worrisome skin lesions. He says many doctors also need reminders that such lesions can be cancers, even when patients have dark skin.

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Flor Mayoral understands why so many of her Hispanic patients ignore warnings about too much sun, never use sunscreen and express absolute shock when they are diagnosed with skin cancer.

The Miami dermatologist says her patients have heard that those most at risk have pale skin, blond hair, blue eyes and freckles. "I am not blond, I don't have blue eyes and I don't have freckles," she says. "So I think you are not talking about me." And it's true that the risk for skin cancer is lower the darker your skin is — meaning most Hispanics and blacks in the USA are at lower risk than most whites.

But lower doesn't mean zero. And, when it comes to melanoma, a dangerous form of skin cancer, a lack of concern can be deadly. Studies show that though blacks and Hispanics are much less likely than whites to get melanoma, they are much more likely to be diagnosed at a late stage and die from it.

One recent study of 41,072 melanoma patients in Florida found advanced cases in 12% of whites, 18% of Hispanics and 26% of blacks

"This is a tragedy because it's preventable," says Claudia Hernandez, a dermatologist in Chicago. "Unlike a lot of cancers that are internal and cannot be seen, these are cancers that can be caught at an early stage."

But Hernandez says her Hispanic and black patients tell her: "We do not get skin cancer."

The issue has captured the attention of major medical groups. At a meeting in June, the American Medical Association passed a resolution calling for greater skin cancer prevention efforts aimed at "communities of color."

This summer, the American Academy of Dermatology is dispatching doctors to discuss the risks on radio stations popular with black and Hispanic listeners.

Mayoral says she'll do those interviews in Spanish. "The message will be that you, too, can get skin cancer," she says. "It doesn't matter what color your skin is: If you have a mole that is changing in size or color or is bleeding, you need to have it looked at."

The AMA resolution said people of all skin colors should use sunscreen, limit sun exposure and have regular skin exams.

The most common skin cancers — those that rarely kill but can be disfiguring — are clearly linked to accumulated damage caused by the sun over a lifetime. The link between sun exposure and melanoma is more complex, but studies suggest indoor tanning, sunburns and bouts of intense exposure (including sun-soaked vacations) do raise the risk.

Everyone should take heed

Sun exposure does have at least one benefit: It boosts vitamin D levels, which are often low in dark-skinned people. But the dermatology group says food and supplements are safer sources.

Still, years of warnings haven't persuaded most whites to cover up. Persuading blacks and Hispanics is much tougher, says Robert Kirsner, a researcher at the University of Miami. In one study, he and his colleagues found Hispanic teens were less likely to use sunscreens, more likely to use a tanning bed and less concerned about skin cancer than white teens — even when their skin tones were the same.

Health groups should warn everyone about sun exposure, he says. But blacks and Hispanics may benefit even more, he says, from campaigns that urge them to see a doctor if they notice new, changing or otherwise worrisome skin lesions. He says many doctors also need reminders that such lesions can be cancers, even when patients have dark skin.